Virus home recovery: Telemedicine providers swamped by patients' calls

Private telemedicine providers here have been tapped to reinforce the Ministry of Health's (MOH) handling of Covid-19 patients on home recovery, but are stretched thin and facing a flood of calls, such that some patients wait up to an hour to see a doctor virtually.

There are at least nine telemedicine providers - including MaNaDr, MyDoc and Speedoc - currently supporting the thousands isolated under home recovery and quarantine order by leveraging mobile apps.

Their role includes screening patients virtually to confirm that they are suitable for home recovery, providing teleconsultations, delivering medication and in-person swabbing.

While many of the providers have supported recovering migrant workers and are familiar with attending to Covid-19 patients, they did not anticipate the flood of local cases over the past two weeks as Singapore battles a large wave of infections.

Daily new local cases have exceeded 1,000 on most days since Sept 18, and more than 40 per cent of patients are on home recovery.

MaNaDr's founder, Dr Siaw Tung Yeng, said the provider's list of patients has been growing by several hundred each day since it started home recovery work on Sept 17.

Since Sunday, more than 500 patients who tested positive and had not heard from the authorities have used the MaNaDr mobile app to request teleconsultations.

So far, MaNaDr has been taking care of more than 2,000 people under home recovery.

MyDoc director of clinical operations Matthew Lee said the platform's service has contacted at least 600 patients and their families since it came on board, and that getting manpower to support 24/7 operations has been a challenge.

He added: "We saw many patients who were unsure of what to do after being diagnosed.

"Our doctors had to spend a longer time with each patient to address all the concerns, while other patients were in the queue."

The faster-than-expected rise in local Covid-19 cases as home recovery was made the norm on Sept 18 meant the authorities had little time to fully scale up their resources, which led to criticism from some patients that they were left with inadequate support.

Last week, MOH said patients who have not yet heard from the authorities can approach telemedicine providers at no charge if they feel unwell.

With new case numbers remaining high, MaNaDr has been getting an influx of video consultation requests throughout the day, with numbers peaking after dinnertime, said Dr Siaw.

Depending on the symptoms and needs, patients have to wait between a few seconds and an hour to receive a call, after sending a video consultation request via MaNaDr's app.

Patients who spoke to The Straits Times said their experience with the teleconsultations has been mixed.

A patient in her 30s, who wanted to be known only as Ms Wong, said the service she was assigned to seemed to be stretched thin.

"I feel sorry for the doctor, who was obviously overwhelmed. He came across to me as disoriented... No medication was offered even though I reported several symptoms."

Ms Wong, who works in shipping, has been self-medicating instead.

Another patient, Ms Adeline Tan, 33, praised her telemedicine provider Speedoc.

"Throughout my whole home recovery journey, it has rendered the most help, and answered all my queries. The doctors were even willing to call me at late hours," said Ms Tan, who works in the pharmaceutical sector.

For telemedicine providers, one key challenge has been getting some new patients on board via the apps.

A spokesman for Doctor Anywhere, one of the providers, said: "We have been told that patients received Covid-19-related scam calls, and this caused some distrust and suspicion in patients when our team made the first call to them."

MaNaDr's Dr Siaw said others had low trust in telemedicine providers because they had spent days waiting for calls and could not reach MOH hotlines.

As such, they were doubtful that the service would stay with them throughout their recovery.

One of the top concerns among patients is that they might infect their family members, with some insisting that they be taken to a community care facility.

Speedoc chief executive Shravan Verma said: "It is also the PSLE period now and if the isolation orders affect the exam-going kids, parents can get even more panicky."

Telemedicine providers said they have been working to scale up their operations by adding and redeploying doctors.

For instance, MaNaDr said it has doctors who log on to help with teleconsultations after work or between seeing patients in person. In the last week, up to 40 new doctors have joined MaNaDr.

More private healthcare providers will also be offering telemedicine services in the coming days.

Home care service Homage is among the providers under official consideration to support home recovery, while Edgedale Medical Clinic has just come on board.

Information about the telemedicine providers can be found at www.moh.gov.sg/covid-19/general/home-recovery-programme---for-patients